血清抗环瓜氨酸肽抗体与类风湿关节炎合并间质性肺疾病的相关性分析

Study on correlation between serum anti-cyclic citrullinated peptide antibody and interstitial lung disease in patients with rheumatoid arthritis

目的探讨血清抗环瓜氨酸肽(CCP)抗体与类风湿关节炎(RA)合并间质性肺疾病(ILD)的相关性。方法选择RA患者共57例,其中RA-ILD患者22例(研究组),RA未合并ILD患者35例(对照组),检测RA患者抗CCP抗体、类风湿因子(RF)、C反应蛋白(CRP)、红细胞沉降率(ESR)、IgG、IgA、IgM水平,采用疾病活动评分(DAS28)评估疾病活动性,并进行统计分析。结果抗CCP抗体在高滴度水平即抗CCP抗体>500 U/ml时,研究组的CCP抗体>500 U/ml的人数比率著高于对照组。两组在各种滴度分组下的RF水平均无统计学差异。研究组RF滴度与抗CCP抗体水平无明显相关性(r=0.192,P=0.637),两组其余各项指标也无统计学差异。结论高滴度抗CCP抗体在评价RA-ILD方面有一定的参考价值,较RF好。对高滴度抗CCP抗体的RA患者应注意间质性肺疾病的发生。

Objective To explore the correlation between serum anti -cyclic citruUinated peptide （CCP） antibodies and interstitial lung disease （ILD） in patients with rheumatoid arthritis （RA） . Methods Fifty seven patients with rheumatoid arthritis admitted in this hospital were selected for this study, among them, 22 patients with RA - ILD were allocated in study group, and 35 patients with rheumatoid arthritis without ILD were allocated in control group. The levels of anti -CCP antibodies, RF, CRP, erythrocyte sedimentation rate （ESR） , IgG, lgA and IgM were examined in patients with RA. Disease Activity Scores （ DAS28 ） were used in assessing the disease activity and statistical analysis. Results The proportion of anti - CCP antibodies in high titer namely ＂anti - CCP 〉 500 U/ml＂ in study group was significantly higher. The difference in RF titers between these two groups was not statistically significant. Titers of level of RF and anti - CCP antibody titer in study group were not significantly correlated （ r = 0. 192, P = 0. 637 ）. The difference in other indicators between these two groups was also not statistically significant. Conclusion The high titers of anti - CCP antibodies have certain referential value in evaluation of RA - ILD, and this indicator is better than RF. High titers of anti - CCP antibodies in patients with RA should be aware of the occurrence of interstitial lung disease.